Facilitators and Barriers to HIV self-testing Among Female Sex Workers in Bulawayo Province 2021

Abstract

Zimbabwe is one of the countries with a high HIV burden in southern Africa with a prevalence of around 13% in the general population. Amongst the ten provinces in Zimbabwe, Bulawayo Province is in the top three provinces most affected by HIV. While HIV testing services in Bulawayo Province are widely available their accessibility has a bias towards the general population as opposed to the high-risk populations. HIV testing among female sex workers remains incommensurate with the need to continuously monitor HIV incidence. This is against the background of an HIV prevalence of 57.1% among female sex workers, 28% amongst prisoners, 23.5% in men who have sex with men and 15% in the general population.The aim of the study was to determine the facilitators and barriers to HIV self-testing among female sex workers at Bulawayo Province in 2021. The study used an unmatched case-control study design and was conducted among 177 convenience sampled female sex workers in Bulawayo Province in 2021. Univariate and multivariate logistic regression analysis was used to analyze the data. The following factors were emerged significant from the univariate analysis; employment status (OR = 3.3, p<0.006), knowledge of were to get tested (OR = 2.0, p<0.030), recent illness (OR = 2.9, p<0.001), having been treated for a sexually transmitted infection (STI) (OR = 2.0, p<0.027, perceived seriousness of HIV infection (OR = 3.3, p<0.001), delays in turnaround time (OR = 0.4, p<0.001), access to peer support (OR = 3.3, p<0.001) and access to HIV information (OR = 0.5, p<0.001). Findings from the multivariate logistic regression revealed several facilitators and barriers such as perceived seriousness of an HIV infection (aOR = 2.7, p<0.01), delays in turnaround time (aOR = 0.3, p<0.001), reporting that hospitals were a private space (aOR = 4.4, p<0.001) and having peer support to do an HIV test (aOR = 3.3, p<0.001). This study strengthens the idea that a more private and conducive hospital environment coupled by good turnaround times in getting test results could improve uptake of HIV selftesting services.